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- Volume 13, Issue 3, 2008
Journal of Endocrinology, Metabolism and Diabetes in South Africa - Volume 13, Issue 3, 2008
Volume 13, Issue 3, 2008
Author Stephen HoughSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 13 (2008)More Less
JEMDSA, the official journal of the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA), has been associated with the South African Medical Association and published by the Health and Medical Publishing Group (HMPG) since its inception more than a decade ago. Now the Society has decided that it is time for a change, and as of 2009 JEMDSA will be published by a private publishing house, Medpharm Publications.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 13, pp 80 –88 (2008)More Less
Type 2 diabetes mellitus (DM) is a disorder that is placing an increasing burden on health service delivery worldwide. Consequently, it has become increasingly important that physicians who treat such patients have a good knowledge of antidiabetic drugs that are currently available or will come onto the market. This article presents an overview of all the major drug classes as well as some information on pharmacokinetics, pharmacodynamics, side-effect profiles and indications for use.
Survey on knowledge and attitudes regarding diabetic inpatient management by medical and nursing staff at Kalafong HospitalSource: Journal of Endocrinology, Metabolism and Diabetes in South Africa 13, pp 90 –97 (2008)More Less
Objective. The objective of this study was to evaluate perceptions regarding current practices in the care of diabetic inpatients as well as the knowledge and attitudes of nursing and medical caregivers at a large secondary hospital.
Design and methods. Doctors and nurses taking care of diabetic inpatients were surveyed to assess their knowledge of diabetes inpatient management and their attitudes towards diabetic patients. The survey made use of the diabetes knowledge questionnaire (O'Brien) and the DAS3 scale.
Results. The survey group comprised 115 health care providers, of whom 54 were doctors and 61 were nurses. The response rate was 82%. The doctors achieved a mean score of 68.3% (standard deviation (SD) 11.5%) and the nurses 53.9% (SD 16.3%) for the diabetes knowledge questionnaire. The DAS3 questionnaire indicated that 80.9% of health care personnel strongly agree that special training for managing diabetic patients is necessary, 90.5% agree or strongly agree that type 2 diabetes is a serious condition, 92.2% agree or strongly agree that tight glycaemic control is valuable, 85.2% agree or strongly agree that diabetes has a significant psychosocial impact on patients, and 88.7% agree or strongly agree that patients should have autonomy regarding their treatment.
Conclusions. Health care workers (doctors and nurses) in a large secondary hospital have average to poor knowledge about the care of diabetic inpatients. The DAS3 questionnaire, however, indicates that health care workers have a good attitude towards diabetic patients and realise that special training is necessary.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 13, pp 98 –104 (2008)More Less
Aims. To determine: (i) the incidence of new-onset diabetes mellitus in patients after renal transplantation (NODM); and (ii) the association between NODM and (a) various immunosuppressive regimens, and (b) ethnicity; and (iii) to assess outcomes in terms of morbidity and mortality associated with NODM, i.e. infections, cardiovascular disease, graft function and survival, and overall patient survival.
Study design. A retrospective analysis of 398 patient files from Johannesburg Hospital for the transplant period 1 July 1994 to 30 June 2004 was conducted. Information regarding patient age, race, date of onset of diabetes, immunosuppressive regimen, infections, and cardiovascular and overall morbidity and mortality was recorded.
Results. Of the patients 15.6% became diabetic (62/398) with a mean time to onset of 22.9 months; 20.2% of black patients (p=0.100), 12.5% of coloured (mixed race) patients, 12.0% of Indian patients and 9.4% of white patients developed NODM. Treatment with cyclosporin A was associated with a 14.4% incidence of diabetes, tacrolimus with an incidence of 20.3% (p=0.228), sirolimus with an incidence of 11.4% and mycophenolate mofetil with an incidence of 12.0%. The patients with diabetes had an infection rate of 96.8% (p<0.0001), cardiovascular mortality of 11.3% (p=0.824) and overall mortality of 26.3%.
Conclusions. The incidence of NODM after transplantation is significant, and the condition confers an increased risk of infections and overall mortality. While black patients are most commonly affected, with the greatest risk among those treated with tacrolimus, this did not reach significance, probably owing to the small numbers.
Source: Journal of Endocrinology, Metabolism and Diabetes in South Africa 13, pp 105 –108 (2008)More Less
Background. The objective of this study was to investigate levels of foot care knowledge among patients attending the diabetes clinic at Pretoria Academic Hospital by comparing the knowledge of patients with 'at risk' feet (ARF) to those with 'normal / not at risk' feet (NARF) and so assess whether the education effort by the clinic is effective.
Methods. Patients attending the clinic completed an interviewer-assisted questionnaire with 11 questions concerning foot care knowledge. A knowledge score for each patient was calculated.
Results. Possible scores ranged from 4 to 11 (maximum 11). The mean score for the ARF group was 8.9 (standard deviation (SD) 1.4) (range 4 - 11) compared with 8.9 (SD 1.4) for the NARF group (range 5 - 11) (p>0.05). The most substantial difference between the two groups was that the ARF group gave 20% more correct answers than the NARF group with regard to frequency of foot inspection (daily) (p=0.025).
Conclusions. Both groups of patients had a reasonable knowledge regarding foot care. The patients at risk were more aware of the need for daily foot inspection.